Implementation of remote home care: assessment guided by the RE-AIM framework.
BMC Health Serv Res
; 24(1): 145, 2024 Jan 29.
Article
em En
| MEDLINE
| ID: mdl-38287394
ABSTRACT
BACKGROUND:
Welfare technology interventions have become increasingly important in home-based palliative care for facilitating safe, time-efficient, and cost-effective methods to support patients living independently. However, studies evaluating the implementation of welfare technology innovations are scarce, and the empirical evidence for sustainable models using technology in home-based palliative care remains low. This study aimed to report on the use of the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to assess the implementation of remote home care (RHC) a technology-mediated service for home-living patients in the palliative phase of cancer. Furthermore, it aimed to explore areas of particular importance determining the sustainability of technologies for remote palliative home-based care.METHODS:
A secondary analysis of data collected by semi-structured interviews with patients with cancer in the palliative phase, focus groups, and semi-structured interviews with healthcare professionals (HCPs) experienced with RHC was performed. A deductive reflexive thematic analysis using RE-AIM dimensions was conducted.RESULTS:
Five themes illustrating the five RE-AIM dimensions were identified (1) Reach protective actions in recruitment - gatekeeping, (2) Effectiveness potential to offer person-centered care, (3) Adoption balancing high touch with high tech, (4) Implementation moving towards a common understanding, and (5) Maintenance adjusting to what really matters. The RE-AIM framework highlighted that RHC implementation for patients in the palliative phase of cancer was influenced by HCP gatekeeping behavior, concerns regarding abandoning palliative care as a high-touch specialty, and a lack of competence in palliative care. Although RHC facilitated improved routines in patients' daily lives, it was perceived as a static service unable to keep pace with disease progression.CONCLUSIONS:
A person-centered approach that prioritizes individual needs and preferences is necessary for providing optimal care. Although technologies such as RHC are not a panacea, they can be integrated as support for increasingly strained health services.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Enfermagem de Cuidados Paliativos na Terminalidade da Vida
/
Serviços de Assistência Domiciliar
/
Neoplasias
Tipo de estudo:
Qualitative_research
Limite:
Humans
Idioma:
En
Revista:
BMC Health Serv Res
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Noruega